Disrespect and abuse during childbirth in East Hararghe Zone public health facilities, eastern Ethiopia: a cross-sectional study.

Background: Compassionate and respectful maternity care during childbirth has been identified as a potential strategy to prevent and reduce maternal mortality and morbidity. Despite its importance, there is a paucity of information on the level of disrespect and abuse meted out to mothers in eastern Ethiopia. This study assesses the level of disrespect and abuse suffered by women during childbirth, and the associated factors, in public health facilities in the rural East Hararghe Zone in eastern Ethiopia. Methods: A cross-sectional study was conducted among 530 women who gave birth in 20 public health facilities in the East Hararghe Zone during the period between 1 April and 30 April 2020. Data were collected using a validated questionnaire. Bivariable and multivariable binary logistic regression analyses were employed to identify the factors associated with disrespect and abuse during childbirth. Adjusted odds ratio (AOR) (95% CI) was used to report this association, and statistical significance was set at P < 0.05. Results: Overall, 77% (95% CI: 73%-81%) of women reported at least one type of disrespect and abuse during childbirth in the East Hararghe Zone public health facilities. In this study, factors such as households having an average monthly income of below 57.22 USD (AOR = 2.29, 95% CI: 1.41-3.71), mothers residing at more than 30 min away from a nearby health facility (AOR = 2.10, 95% CI: 1.30-3.39), those not receiving antenatal care (AOR = 4.29, 95% CI: 2.17-8.52), and those giving birth during nighttime (AOR = 2.16, 95% CI: 1.37-3.41) were associated with at least one type of disrespect and abuse during childbirth. Conclusion: More than three in every four women who gave birth in the East Hararghe Zone public health facilities were disrespected and abused during childbirth. Encouraging all pregnant women to pay attention to antenatal care visits and improving the quality of healthcare service during nighttime in all health facilities will be essential for preventing and reducing disrespect and abuse and its negative consequences.

Adherence to diabetic foot care recommendations and associated factors among people with diabetes in Eastern Ethiopia: a multicentre cross-sectional study.

OBJECTIVE: This study aimed to determine the level of adherence to foot care recommendations and associated factors among people with diabetes on follow-up in public hospitals in Eastern Ethiopia. SETTING: An institutional-based cross-sectional study was conducted in public hospitals found in Eastern Ethiopia from 25 February to 25 March 2022. PARTICIPANTS: A total of 419 patients with chronic diabetes who visited diabetic clinics in public hospitals in Eastern Ethiopia for follow-up were included. MAIN OUTCOME MEASURE: The level of adherence to diabetic foot care recommendations and associated factors. RESULTS: The findings indicated that 44.3% (95% CI: 39.3, 49.0) of people with diabetes had inadequate adherence to diabetic foot care recommendations. Age between 28-37 (adjusted OR (AOR)=1.10; 95% CI: 1.27, 5.63) and 38-47 years (AOR=2.19; 95% CI: 2.74, 8.89), rural residence (AOR=1.71; 95% CI: 1.15, 2.57), absence of comorbidity (AOR=2.22; 95% CI:1.34, 5.14), obesity (AOR=1.43; 95% CI: 1.10, 5.05) and inadequate foot care knowledge (AOR=2.10; 95% CI: 1.52, 4.35) were factors significantly associated with inadequate adherence to diabetic foot care recommendations. CONCLUSION: More than two-fifths of people with diabetes had inadequate adherence to diabetic foot care recommendations. Younger age, rural residence, absence of comorbidity, obesity and inadequate foot care knowledge were significantly associated with inadequate adherence to diabetic foot care recommendations. It is very essential to educate people with diabetes about the importance of foot care recommendations in preventing and delaying the risks of foot-related problems and complications.

Cultural malpractice during pregnancy, childbirth, and the postnatal period and its associated factors among women who gave birth once in Dire Dawa city administration, Eastern Ethiopia, in 2021.

Background: Cultural practices are any experiences or beliefs that are socially shared views and behaviors practiced in a certain society at a certain time. Cultural malpractices are defined as socially shared views and traditionally accepted behaviors experienced in a certain society that harm maternal health. Worldwide, the period of pregnancy, labor, and delivery is embedded with different beliefs, customs, and rituals in different societies that contribute a lot to maternal death. They are responsible for the annual deaths of 303,000 mothers and 2.7 million newborns globally. In developing countries, it accounts for approximately 5%-15% of maternal deaths. In Ethiopia, approximately 18% of infant deaths occur due to cultural malpractice, and 52% of pregnant mothers give birth at home following cultural customs in Dire Dawa city. The objective of this study was to assess cultural malpractices during pregnancy, childbirth, and the postnatal period and its associated factors among women who gave birth once in Dire Dawa City in 2021. Methods: Community-based mixed study was conducted. A total of 624 study participants were selected through a systematic random sampling technique, and a purposive sampling method was used for qualitative data. The study was conducted in the randomly selected Kebeles of Dire Dawa City, Eastern Ethiopia, from November 1 to December 30, 2021. Data were entered into Epi Data version 4.1 and exported to SPSS version 24 for analysis. Bivariate and multivariate analyses were done, and the degree of association was measured by using the odds ratio with 95% CI and significance was declared at a p-value of <0.05. The qualitative data were analyzed thematically using ATLAS-ti version 7. Results: The overall prevalence of cultural malpractice during pregnancy, childbirth, and the postnatal period was 74.6% [95% CI: 70.59%, 77.49%]. Women over the age of 35 were two times more likely [AOR 2.61, 95% CI, 1.45-4.72] to commit cultural malpractice than women aged 15-24 and 25-34. Those with no antenatal care (ANC) follow-up were three times more likely to commit cultural malpractice [AOR 3.57, 95% CI, 1.72-7.40], those who were absent from health education were nearly two times more likely to commit cultural malpractice [AOR 1.83, 95%CI, 1.25-2.67], and women whose culture allows harmful traditional practices were nearly two times more likely to commit cultural malpractices than their counterparts [AOR 1.69, 95%CI, 1.29-2.54]. Conclusion: In this study, nearly three-fourths of participants were involved in cultural malpractices. Therefore, strengthening community education and behavioral change messages on the importance of ANC and avoiding unhealthy care during pregnancy, childbirth, postnatal and neonatal periods, especially with pregnancy at old age (age > 35), may help to reduce cultural malpractices.

Evaluating Khaya senegalensis for Dipeptidyl Peptidase-IV Inhibition Using in Vitro Analysis and Molecular Dynamic Simulation of Identified Bioactive Compounds.

The dipeptidyl peptidase-IV (DPP-IV) inhibitory activity of Khaya senegalensis extracts was evaluated. The DPP-IV from a rat kidney was purified to a purification fold of 2.3. Among extracts from K. senegalensis, the hexane extract had the best DPP-IV inhibitory activity, with IC50 value of 1.56±0.61 µg/mL and was fractionated to eleven fractions (A-K). Fraction I had the best DPP-IV inhibition via uncompetitive pattern. GC-MS analysis of fraction I showed that the major bioactive compounds were 3-amino-3-hydroxyimino-N-phenylpropanamide (1) and 11-(2-cyclopenten-1-yl)undecanoic acid (2), with good binding affinities toward DPP-IV, based on molecular docking,. They were then subjected to molecular dynamic simulation using WEBGRO and utilizing a GROMACS system for 100 ns. The 3-amino-3-hydroxyimino-N-phenylpropanamide-DPP-IV complex was more stable and compact than the other complex. K. senegalensis contains compounds like 1 that might be used for the design of new DPP-IV inhibitors.

Determinants of short birth interval among married multiparous women in Chinaksen district, eastern Ethiopia: a case-control study.

Background: The short birth interval is a common public health issue that affects women's and children's health in sub-Saharan Africa. Despite a higher burden of short birth intervals reported in Ethiopia, there is limited evidence to indicate the primary risk factors, particularly in rural eastern Ethiopia. Therefore, this study assessed the determinants of the short birth interval among married multiparous women in Chinaksen district, Eastern Ethiopia. Methods: A community-based case-control study was conducted among randomly selected 210 cases and 210 controls from April 01 to June 30, 2019. The total sample size (219 cases and 219 controls) were calculated using Epi-Info software version 7.2. Data were entered using EpiData version 3.1 and analyzed using SPSS version 27, and multivariable logistic regression analyses conducted to identify the determinants of short birth intervals. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report the strength of association and statistical significance declared at p-value < 0.05. Results: The women in the young age group (AOR = 2.33, 95% CI: 1.03, 5.26), missed their antenatal care visits (AOR = 2.23, 95% CI: 1.18, 4.21), failed to utilize postpartum contraceptives (AOR = 5.98, 95% CI: 3.62, 9.89), did not attend postnatal care visit (AOR = 1.86, 95% CI: 1.13, 3.05), nonexclusive breastfed (AOR = 4.05, 95% CI: 2.18, 7.52), short and medium period of breastfeeding (AOR = 4.00, 95% CI: 1.34, 12.10) and (AOR = 3.56, 95% CI: 1.62, 7.82), respectively and female sex of preceding child (AOR = 1.92, 95% CI: 1.18, 3.12) were the important risk factors of short birth interval. Conclusions: Women's age, antenatal care visits, postnatal care attendance, utilization of postpartum contraceptives, exclusive breastfeeding practice, duration of breastfeeding, and sex of the preceding child were the primary predictors of short birth intervals. Improving the utilization of maternal healthcare services in health facilities would be imperative to prevent and reduce short birth intervals, and its negative consequences.

The role of polio emergency operations centers: perspectives for future disease control initiatives in Nigeria.

The Nigeria Polio Emergency Operations Centre (EOC) was established in October 2012 to strengthen coordination, provide strategic direction based on real-time data analysis, and manage all operational aspects of the polio eradication program. The establishment of seven state-level polio EOCs followed. With success achieved in the interruption of wild poliovirus (WPV) transmission as certified in 2020, the future direction of the polio EOC is under consideration. This paper describes the role of the polio EOC in other emergencies and perspectives on future disease control initiatives. A description of the functionality and operations of the polio EOC and a review of documentation of non-polio activities supported by the EOC was done. Key informant insights of national and state-level stakeholders were collected through an electronic questionnaire to determine their perspectives on the polio EOC's contributions and its future role in other public health interventions. The polio EOC structure is based on an incident management system with clear terms of reference and accountability and with full partner coordination. A decline in WPV1 cases was observed from 122 cases in 2012 to 0 in 2015; previously undetected transmission of WPV1 was confirmed in 2016 and all transmission was interrupted under the coordination of the EOCs at national and state levels. During 2014-2019, the polio EOC infrastructure and staff expertise were used to investigate and respond to outbreaks of Ebola, measles, yellow fever, and meningitis and to oversee maternal and neonatal tetanus elimination campaigns. The EOC structure at the national and state levels has contributed to the positive achievements in the polio eradication program in Nigeria and further in the coordination of other disease control and emergency response activities. The transition of the polio EOCs and their capacities to support other non-polio programs will contribute to harnessing the country's capacity for effective coordination of public health initiatives and disease outbreaks.

Deployment of novel oral polio vaccine type 2 under emergency use listing in Nigeria: the rollout experience.

In 2011, a dedicated consortium of experts commenced work on the development of the novel oral poliovirus vaccine type 2 (nOPV2). After careful and rigorous analysis of data to enable early, targeted use of the vaccine, World Health Organization´s (WHO´s) Strategic Advisory Group of Experts on Immunization (SAGE) reviewed data from accelerated clinical development of nOPV2 and endorsed entering assessment under WHO´s Emergency Use Listing (EUL) procedure. In November 2020, nOPV2 received an interim recommendation for use under EUL to enable rapid field availability and potential wider rollout of the vaccine. In December 2020, Nigeria initiated preparation to meet all criteria for initial use of nOPV2 in the country and the documentation process to verify meeting them. The process entailed addressing the status of meeting 25 readiness criteria in nine categories for nOPV2 use in Nigeria for response efforts to ongoing cVDPV2 outbreaks. During January-February 2021, Nigeria submitted the required documentation for all required indicators for nOPV2 initial use. In February 2021, the country obtained approval from the GPEI nOPV2 Readiness Verification Team to introduce nOPV2 and in March 2021, rolled out the novel vaccine in mass vaccination campaigns for outbreak response in Bayelsa, Delta, Niger, Sokoto and Zamfara states, and one area council in the Federal Capital Territory (FCT). The lessons learned from this rollout experience in Nigeria are being applied as the country streamlines and strengthens the nOPV2 rollout process across the remaining states.

Adenoid and Tonsil Hypertrophy in Zaria, North Western Nigeria: Review of Clinical Presentation and Surgical Outcome.

Background: Adenotonsillar hypertrophy is one of the most common childhood disorder that necessitates presentation to the ear nose and throat specialist. The disorder may be managed conservatively or by surgery. Aim: To highlight the clinical presentation and surgical treatment outcome of patients managed for adenoid and tonsillar hypertrophy at Ahmadu Bello University Teaching Hospital Zaria, Nigeria. Materials and Methods: The case records of patients managed for adenoid and tonsil hypertrophy were reviewed from January 2013 to December 2017 at the Division of Otorhinolaryngology, Department of Surgery Ahmadu Bello University Teaching hospital Zaria, - Northwestern Nigeria. Case notes with incomplete information and /or missing pages were excluded. The data were analyzed using IBM SPSS (for windows, version 23). Results: There were 56 (55.4%) males and 45 (44.6%) females with male to female ratio of 1.2:1. Their ages ranged from 2-16 years with a mean and standard deviation of 4.0 and 3.2 respectively. The most common symptom at presentation was snoring 85 (84.2%) followed by rhinorrhea 81(80.2%). Findings from the radiologic investigations revealed that majority of the patients had severely narrowed nasopharyngeal air column 83(82,2%) Adenotonsillectomy was the most common surgery performed on most of the patients 63(62.4%) who presented with adenotonsillar hypertrophy. Majority of the patients 95(94.1%) had resolution of symptoms within the period of follow up. Four (4.0%) of them had recurrent adenoidal growth. Conclusion: Snoring, rhinorrhea and mouth breathing were the most common symptoms of adenotonsillar hypertrophy. The outcome of adenotonsillar surgeries in our patients is good, with the majority having resolution of symptoms.

Women experiencing homelessness in Dire Dawa city: Coping mechanisms and suggestions to stakeholder, 2021.

BACKGROUND: In Ethiopia, the number of homeless girls and women is increasing, and the government has yet to devise a strategy to address the issue of teenage homelessness. They are influenced by numerous dimensions of health, including physical health, mental health, and social isolation. At all stages of homelessness, the stakeholders and homeless people must work together to address the issue. As a result, this study will be helpful to generate relevant data that may guide policymakers in designing solutions for this underserved group of people. OBJECTIVES: To explore coping mechanisms and suggestions to stakeholders among women experiencing homelessness in Dire Dawa city, eastern Ethiopia, 2021. DESIGN: A community-based phenomenological qualitative study was conducted at Dire Dawa city. METHODS: Data were collected from women experiencing homelessness and key informants through focus group discussion and in-depth interviews using a semi-structured tool. A total of 31 women experiencing homelessness (13 in-depth interviews and 3 focus group discussion with 6 participants in each) and 2 key informants participated in this study. Data were analyzed thematically using computer-assisted qualitative data analysis software Atlas.ti 7. The thematic analysis follows six steps: familiarization, coding, generating themes, reviewing themes, naming themes, and writing up. RESULTS: Two major themes were driven: coping mechanisms and suggestions to stakeholders. There are three subthemes under the coping mechanism (begging, survival sex, and child prostitution) while there are a total of seven subthemes under suggestions to stakeholders (integration and collaboration, special attention to children, family education, shelter and job, schooling, sexual education, and addiction rehabilitation). CONCLUSION: Child prostitution and survival sex are a very common coping mechanism which is practiced by women experiencing homelessness. Changing society's mindset and paying special attention to children is critical. Furthermore, the government and various stakeholders should work together to develop a rehabilitation program for street children who have been exposed to substance use.

'The show must go on!': Hustling through the compounded precarity of Covid-19 in the creative industries.

The article offers a qualitative examination of compounded precarity in creative work during the Covid-19 pandemic. Drawing on repeated in-depth interviews with twelve creative workers operating in the creative industries in Ghana, we examine one of the most prevalent practices for navigating, coping with, and managing compounded precarity: that of hustling. We empirically identify and discuss three interrelated practices of hustling in creative work: digitalization, diversification, and social engagement. We present a new way of conceptualizing creative work in precarious geographies by theorizing hustling, and the associated worker resourcefulness, improvisation, savviness, hopefulness, and caring not merely as an individualized survival strategy, but rather as an agentic and ethical effort to turn the vicissitudes of life into situated advantages and opportunities, and even social change.

Tiger nut (Cyperus esculentus L.) and date palm (Phoenix dactylifera L.) fruit blend mitigates hyperglycemia, insulin resistance and oxidative complications in type-2 diabetes models.

Tiger nut and date fruit are chewy with sweet taste and are popularly consumed as food either alone, mixed or paired with other fruits, seeds and vegetables. They are locally used to treat diabetes and were separately reported to attenuate hyperglycemia in various animal models of diabetes. However, effect of tiger nut and date fruit mixture on key diabetes related parameters has not yet been reported. Therefore, we investigated the antidiabetic and antioxidant effects of the tiger nut and date blend (TDB) using in vitro and in vivo models. The TDB was prepared in equal ratio (1:1). For the in vivo study, mixture was included in the diet at 5% and 10% and feed the type 2 diabetic rats for 4 weeks. The diabetic untreated rats showed significant (p < .05) hyperglycemia, hyperlipidemia, insulin resistance and oxidative stress. Consumption of the TDB blend, significantly (p < .05) reduced fasting blood glucose by 71% and 52% in the groups treated with high and low doses respectively. In addition, intake of TBD blend demonstrated significant (p < .05) antihyperlipidemic, ameliorated insulin resistance and oxidative stress in the treated groups. The effects were more prominent in group supplemented with the 10% of the TDB and attributed to some promising ingredients detected. In conclusion, dietary supplementation of TDB exhibited antidiabetic action and could be due to the phytochemicals assessed. PRACTICAL APPLICATIONS: Inclusion of functional foods such as tiger nut and date fruit in daily diet is proved to be highly beneficial in controlling type-2 diabetes and its associated complications. Our results show that tiger nut and date fruit blend can effectively reduce hyperglycemia and oxidative damage, improve insulin sensitivity in type-2 diabetes rat model. Hence, the data shows the potential of tiger nut and date fruit blend to promote scientific basis of the dietary application of tiger nut and date fruit blend as a functional food for the remedy of diabetes and its associated complications.

Potential of diterpenes as antidiabetic agents: Evidence from clinical and pre-clinical studies.

Diterpenes are a diverse group of structurally complex natural products with a wide spectrum of biological activities, including antidiabetic potential. In the last 25 years, numerous diterpenes have been investigated for antidiabetic activity, with some of them reaching the stage of clinical trials. However, these studies have not been comprehensively reviewed in any previous publication. Herein, we critically discussed the literature on the potential of diterpenes as antidiabetic agents, published from 1995 to September, 2021. In the period under review, 427 diterpenes were reported to have varying degrees of antidiabetic activity. Steviol glycosides, stevioside (1) and rebaudioside A (2), were the most investigated diterpenes with promising antidiabetic property using in vitro and in vivo models, as well as human subjects. All the tested pimaranes consistently showed good activity in preclinical evaluations against diabetes. Inhibitions of α-glucosidase and protein tyrosine phosphatase 1B (PTP 1B) activities and peroxisome proliferator-activated receptors gamma (PPAR-γ) agonistic property, were the most frequently used models for studying the antidiabetic activity of diterpenes. The molecular mechanisms of action of the diterpenes include increased GLUT4 translocation, and activation of phosphoinositide 3-kinase (PI3K) and AMP-activated protein kinase (AMPK)-dependent signaling pathways. This review revealed that diterpenes hold promising antidiabetic potential while stevioside (1) and rebaudioside A (2) are the only diterpenes that were advanced to the clinical trial stage of the drug discovery pipeline. Diterpenes belonging to the abietane, labdane, pimarane and kaurane classes have shown promising activity in in vitro and in vivo models of diabetes and should be further investigated.

Knowledge and involvement of husbands in the reproductive rights of women in Harar, eastern Ethiopia.

OBJECTIVE: Reproductive rights violations are a serious public health concern worldwide, particularly in Sub-Saharan Africa, where more than 38.83% of victims live. Understanding the status of husbands' knowledge and involvement helps to establish important programs and interventions. However, there are limited data related to husbands' roles in women's reproductive rights in the study setting. Therefore, this study aimed to assess husbands' knowledge and involvement in women's reproductive rights and their associated factors in Harar, eastern Ethiopia. METHODS: A community-based cross-sectional study was conducted among 611 husbands in March 2020. A systematic random sampling technique was used to select the study participants. Data were collected using a structured and pretested interviewer-administered questionnaire. Data were entered using EpiData 3.1 and analyzed with SPSS Version 22. A multivariable logistic regression model was applied to examine the factors associated with the outcome variable using an adjusted odds ratio with a 95% confidence interval, and a p-value < 0.05 was considered statistically significant. RESULTS: The levels of husbands' knowledge and involvement were 48.3% and 40.1%, respectively. Social media utilization (adjusted odds ratio = 4.97, 95% confidence interval = 2.79-8.85), partners' discussion (adjusted odds ratio = 2.33, 95% confidence interval = 1.60-3.39), and type of facility: hospital (adjusted odds ratio = 3.21, 95% confidence interval = 1.23-8.36) and health post (adjusted odds ratio = 2.86, 95% confidence interval = 1.20-6.94) were factors associated with knowledge of husbands. Likewise, the experience of using reproductive services (adjusted odds ratio = 2.15, 95% confidence interval = 1.52-3.03), partner discussion (adjusted odds ratio = 1.95, 95% confidence interval = 1.35-2.82), social media utilization (adjusted odds ratio = 1.74, 95% confidence interval = 1.05-2.89), and age 40-49 years (adjusted odds ratio = 1.99, 95% confidence interval = 1.19-3.32) were factors associated with husbands' involvement. CONCLUSION: Less than half of the husbands were knowledgeable and involved in executing partners' reproductive rights. Promoting and creating effective media utilization is important for creating awareness of reproductive rights. Moreover, working on reproductive health service utilization, women empowerment, and making open discussions between partners are crucial to increase the knowledge and involvement of husbands.

Paediatric neck masses in Zaria: A review of clinical profile and treatment outcome.

BACKGROUND: A neck mass is any abnormal lesion in the neck that can be seen, palpated, or identified on imaging. It is one of the most common reasons for presentation to the surgical clinics. AIM: the aim is to analyse the clinical presentation and treatment outcome in children who were diagnosed and managed for neck masses in a tertiary centre in Northwestern Nigeria. MATERIALS AND METHODS: The records of patients managed for neck masses over 7 years between January 2013 and December 2019 were reviewed. Demographic and clinical data were retrieved and analysed using Statistical Product and Service Solution version 23.0 software (SPSS Inc., Chicago, Illinois, USA). RESULTS: A total of 99 cases were reviewed and there were 52 (52.5%) males and 47 (47.5%) females with male-to-female ratio of 1.1:1, and mean age ± standard deviation of 4.4 ± 3.9 years, the primary complaints of all the patients were neck swellings. The anterior triangle was the most common region involved in 86 (86.9%) patients. The majority of the neck masses were congenital, accounting for 71 (71.8%) patients. Ultrasound scanning was the most commonly requested radiological investigation done in 87 (87.8%) patients. .: Thyroglossal duct cyst was the most common paediatric neck mass seen in 41 (41.4%) patients. The majority of the patients 68 (68.7%) had an excisional biopsy of the lesion. Surgical site infection was the most common complication noted in 7.1% of the study population. CONCLUSION: Most of the neck masses were congenital and were managed surgically. Prompt diagnosis with appropriate treatment may result in a good outcome.

HIV-associated nephropathy: Protocol and rationale for an exploratory genotype-phenotype study in a sub-Saharan African population.

BACKGROUND: HIV-positive persons of African descent are disproportionately affected by chronic kidney disease (CKD). Deterioration to end-stage kidney disease (ESKD) also occurs in this population at a higher frequency. There remains a lot to learn about the genetic susceptibility to CKD in HIV positive patients, and the pathophysiology of progression to ESKD. OBJECTIVES: We will conduct an exploratory genotype-phenotype study in HIV-positive persons with CKD in Aminu Kano Teaching Hospital, Nigeria, to determine blood-based differential gene expression biomarkers in different kidney risk groups according to the KDIGO 2012 criteria. METHODS: We will consecutively screen 150 HIV-positive adults (≥18 years of age) attending the HIV clinic of Aminu Kano Teaching Hospital, Kano, Nigeria, for CKD based on proteinuria and elevation of estimated glomerular filtration rate. Among these, two separate groups of 16 eligible participants each (n = 32) will be selected in the four (4) KDIGO 2012 kidney risk categories. The groups will be matched for age, sex, viral suppression level and antiretroviral (ARV) regimen. In the first group (n = 16), we will determine differential gene expression markers in peripheral blood mononuclear cells using mRNA-sequencing (RNA-Seq). We will validate the differential expression markers in the second group (n = 16) using reverse transcription quantitative polymerase chain reaction (RT-qPCR). Using a systems-based approach, we will construct, visualize and analyze gene-gene interaction networks to determine the potential biological roles of identified differential expression markers based on published literature and publicly available databases. RESULTS: Our exploratory study will provide valuable information on the potential roles of differential expression biomarkers in the pathophysiology of HIV-associated kidney disease by identifying novel biomarkers in different risk categories of CKD in a sub-Saharan African population. The results of this study will provide the basis for population-based genome-wide association studies to guide future personalized medicine approaches. CONCLUSION: Validated biomarkers can be potential targets for the development of stage-specific therapeutic interventions, an essential paradigm in precision medicine.

Clinical Practice Competence and its Associated Factors Among Midwifery and Nursing Students at Dire Dawa Health Sciences Colleges, East Ethiopia, 2020.

BACKGROUND: Competence is defined as the ability to perform a task with desirable outcomes. Globally, an estimated 530,000 women and 2 million newborns die each year, because of no access to competent health professionals. But half of those deaths can be prevented with competent health professionals. However, the existing literature shows that most new graduates have a lack of competence in the clinical environment, none of them have assessed whether student or preceptor factors have an association with clinical competence or not. So, this study is crucial to fill data scarcity. OBJECTIVE: To determine the clinical practice competence and associated factors among midwifery and nursing students at Dire Dawa. METHODS: Institutional cross-sectional study was conducted on nursing and midwifery students from February 10/2020 to February 30/2020. Self-administered questionnaires were given to 318 students through a simple random lottery. Multivariate logistic regression analysis was done for variables with a p-value <0.2 in binary logistic regression. The odds ratio was used to measure the degree of association. RESULTS: Only 19.2% are clinically competent. Students who were oriented about assessment methods were 4 times more likely competent [AOR = 4.096 p-value 0.035]. Students who have staff encouragement and have preceptors were 5 times [AOR = 4.900 p-value 0.12] and 11 times [AOR = 11.052 p-value 0.00] more likely competent, respectively. Confident students were 4 times more likely competent [AOR = 4.460, p-value 0.005]. CONCLUSION: The prevalence of clinical competence is very minimal. This is due to assessment methods orientation, staff encouragement, clinical preceptor support and students' confidence. This finding contributes to the federal ministry of health should work closely with teaching institutions, health facilities, and other stakeholders to overcome those gaps.

Oleanolic acid as a potential antidiabetic component of Xylopia aethiopica (Dunal) A. Rich. (Annonaceae) fruit: bioassay guided isolation and molecular docking studies.

The present study was designed to conduct the bioassay-guided isolation of possible bioactive compound(s) responsible for the antidiabetic action of Xylopia aethiopica (Dunal) A. Rich. fruit. The isolation of compound was guided by α-glycosidase and α-amylase inhibitory activities. Molecular docking with Autodock Vina was used to decipher the mode of interaction and binding affinity of the possible compound(s) with the selected enzymes. A pentacyclic triterpene, oleanolic acid (OA) was isolated from fruit and exhibited significantly (p < 0.05) lower IC50 values (α-amylase: 89.02 ± 1.12 µM, α-glucosidase: 46.05 ± 0.25 µM) than other fractions and the acarbose. Interestingly, OA was found to bind to the α-amylase and α-glucosidase with minimum binding energy values of -0.9 and -1.2 kcal/mol respectively and none of the interactions involved hydrogen bond formation. Data of this study suggest that OA is responsible for the antidiabetic action of X. aethiopica fruit through the inhibition of α-amylase and α-glucosidase enzyme activities.

Audiologic Evaluation of Patients with Head and Neck Cancers Treated with Cisplatin Based Chemotherapy: A Longitudinal Study.

Background: Recently, the incidence of head and neck cancers are on the increase globally and particularly in our environment. In addition, concurrent platinum-based chemoradiotherapy has become widely used in the treatment of head and neck malignancies. The objective of this study was to determine the effect of cisplatin-based chemotherapy on hearing in patients with head and neck cancers at our University Teaching Hospital. Methodology: This was a hospital-based longitudinal case-control study that involved 54 participants attending the oncology treatment centre of the University Teaching Hospital Zaria. The study investigated the hearing threshold and degree of hearing loss pre and post cisplatin-based chemotherapy at intervals of 3 months and 6 months. The data obtained were analyzed using Statistical Product and Service Solutions (SPSS)version 20. Results: Seventy-two participants were recruited into the study, but 54 (75%) participants met the inclusion criteria and were enrolled and as well as same age and sex match controls. Thirty-one31(57.4%) of the participants had a nasopharyngeal tumour, 14(25.9%) had Sinonasal tumour and 9(16.7%) had Laryngeal tumour. Among the study group, there were 39 males (72.2%) and 15 females (27.8%) with an M: F ratio of 2.6:1. The age of the participants ranged from 13-68 years. (Mean =40.3years. SD=13.6). Assessment of hearing in the better ear showed 22 (40.7%) of subjects and 6 (11.1%) of controls had hearing loss before the onset of the study. The majority of these patients had mild hearing loss either mixed or SNHL. In the study group, 32(29.6%) ears showed changes in hearing threshold after 3 months of cisplatin therapy while68(62.9%) ears showed changes at 6 months of therapy. The overall incidence of ototoxicity after 6 months of therapy was 62.9%. Conclusion: This study found a significant number of head and neck cancers patients with hearing impairment pre-chemotherapy. Cisplatin treatment-based chemotherapy was associated with significant short term hearing impairment in patients with head and neck cancers.

Antidiabetic potential of anthraquinones: A review.

The present study was designed to review the antidiabetic potential of anthraquinones (AQs) with emphasis on the extent of blood glucose reduction, the half maximal inhibitory concentration values (in vitro studies), the proposed mechanisms of action, and the structure activity relationship studies. We sourced relevant data from the major scientific databases (Pubmed, Science Direct, Medline, and Google Scholar). According to our search, 25 AQs have shown variable antidiabetic potential, whereas one AQ (morindone-6-O-ß-D-primeveroside) showed no blood glucose-lowering ability. Emodin and rhein showed the most promising antidiabetic potential in various models. The proposed mechanisms of antidiabetic action include upregulation of insulin receptor substrates-1, phosphoinositide-3-kinase, and Akt-ser473 expression and elevation of glucagon-like peptide-1 level in diabetic animal models linked to the potent protein tyrosine phosphatase 1B and dipeptidyl peptidase-4 inhibitions. In addition, activation of peroxisome proliferator-activated receptors gamma and inhibition of α-glucosidase activity are other possible targets proposed as the mechanism of AQs antidiabetic action. The position and the number of hydroxyl group showed great influence on the overall antidiabetic potential of AQs. AQs hold promising antidiabetic activity despite scanty information. We hope that the present study will serve as a template to further explore the antidiabetic potential of AQs and subsequent antidiabetic drug development.

Spice-Derived Bioactive Ingredients: Potential Agents or Food Adjuvant in the Management of Diabetes Mellitus.

Spices possess tremendous therapeutic potential including hypoglycemic action, attributed to their bioactive ingredients. However, there is no study that critically reviewed the hypoglycemic potency, safety and the bioavailability of the spice-derived bioactive ingredients (SDBI). Therefore, the aim of the study was to comprehensively review all published studies regarding the hypoglycemic action of SDBI with the purpose to assess whether the ingredients are potential hypoglycemic agents or adjuvant. Factors considered were concentration/dosages used, the extent of blood glucose reduction, the IC50 values, and the safety concern of the SDBI. From the results, cinnamaldehyde, curcumin, diosgenin, thymoquinone (TQ), and trigonelline were showed the most promising effects and hold future potential as hypoglycemic agents. Conclusively, future studies should focus on improving the tissue and cellular bioavailability of the promising SDBI to achieve greater potency. Additionally, clinical trials and toxicity studies are with these SDBI are warranted.